Supraspinatous---An Essential Muscle of the Shoulder

     The supraspinatous is a small but powerful muscle located in our back, along the top part of our shoulderblade, or scapula. It connects the scapula with the top of the humerus, the bone in our upper arm, and is essential in our ability to raise our arm (abduction).  

     Technically, it is one of the muscles of the rotator cuff, and is commonly affected in rotator cuff injuries.

     A simple orthopedic test rules out an injury to this muscle. However, if the test is positive and involves a tear in the supraspinatous, treatment may require surgery.  

Over-The-Counter Orthotics

Patients who have fallen arches or who pronate need to support their feet with orthotics, not just for comfort, but also because these conditions in the feet reverberate up into the knees, hips, and pelvis and cause problems. Some may need prescription orthotics, but many people will find over-the-counter orthotics can do the job.

I commonly recommend a patient try one of two types that they can buy “off the rack.” One is softer, made of foam, with a mild arch support, that is easy to get used to. The other is a harder, molded orthotic appropriate for people who need more support. Either should be appropriately fitted by a staff person at the store who knows how to size them.

It’s not a bad idea to start with an over-the-counter orthotics and see if they will be sufficient. Certainly they are kinder on the patient’s wallet. If it turns out more fine-tuned or specialized support is needed, prescription orthotics are the next step.   

Polypharmacy

Literally, this means “the simultaneous use of multiple drugs by a single patient for one or more conditions.”

There are now patients coming into my office who are taking upward of eleven or twelve different medications. Often their meds are prescribed by different doctors, and there may be no one doctor who is overseeing or coordinating the mix. Potential harmful drug interactions are not being monitored, and the patient is subject to a myriad of side effects of the various drugs.

Sometimes the pharmacist who fills the patient’s prescriptions may be serving as overseer or monitor, but this is not always the case.

For patients on multiple medications, I advise them to talk with their primary care physician about making sure some caregiver is fulfilling this role.

Numbness, Tingling in Arm or Hand

Nerve impingement of the brachial plexus, the nerves exiting the spine in the neck, can be the cause of numbness or tingling in the arm and / or hand. If the alteration of sensation is diffuse throughout the upper extremity, all or most of the nerves in the brachial plexus may be affected, sometimes due to impingement between the clavicle and the first rib, or in passage between the scalene muscles at the sides of the neck. However, if only parts of the arm or hand are affected, it may be possible to pinpoint the specific spinal nerves that are being impinged. This can guide the specific Activator Chiropractic adjustment which can help alleviate the problem.

From Ribs to No Ribs: Transition Areas of the Spine

     There are two areas of transition in our spine, one at the base of our rib cage and one at the top of it. They are called “transition” areas because they are where attachment of the ribs begin at the lower and upper borders of the rib cage. 

     These are often trouble spots because they are “transitions” from regions of comparatively less mobility to ones of comparatively more mobility. For example, in the low back, the lumbar region, where no ribs attach, is comparatively more mobile than the thoracic region, where, from T12 and up, ribs attach on each side at each vertebral level. 

     Similarly, where ribs cease to attach in the upper back, around T2 & T1, there is a transition to the cervical, comparatively more mobile, region. 

     These transition areas are more vulnerable to biomechanical stresses, and can be recurring trouble spots for some people.